5. Existing problems and countermeasures
7/11/2003 18:19
5. Existing problems and countermeasures
The problem of Shanghai's
community medical service lies in three aspects:
--Lack of family physicians
in community medical service;
--Community medical aid service is similar to
that in traditional hospitals;
--Infancy of operational and governmental
supportive system.
In order to solve these problems, the city's
government seeks to explore a new type of public health care with the following
steps:
5.1 Reform in service mode
The city is examining a "family
physician team" service model [mode]. The community medical service center in
each neighborhood will establish a family physician team, consisting of family
physicians assisted by nursing and health care staff. The center will keep a
record of the health condition of each community member, and give medical
education and health care assistance accordingly. The principle of this model
[mode] is to make disease prevention a priority of medical service, and combine
prevention with treatment. The model [mode] will help identify serious patients
that need to be transferred to higher levels of medical institutes, at the same
time, it will give diagnosis, treatment and recovery aid for those common,
frequently-occurring diseases and diagnosed chronic disease.
Community
medical service centers are reforming their functions. The center is no longer
an assembly of various specialized medical departments. Instead, it now becomes
a team of family physicians guarding the health of all community members.
Therefore, the center is turned into a channel through which the government
provides medical service to community members.
Based on the reform of
service model [mode], the community medical service centers should increase its
service to cope with the aging population, the changing disease spectrum, and
the increasing demand for chronic, non-infectious disease prevention and
treatment. New service items, such as family health care, family nursing,
hospice care and other needed items, will be added to the service
list.
5.2 Speed the building of a family physician
team
Shanghai has already established a technical post evaluation system
for family physician. In order to meet the demand for family doctors in
community medical service center, the city is changing specialist doctors into
family doctors on trial basis. Moreover, specialized doctors from the lower
levels of medical institutes are encouraged to sit for the family physician
qualification test held by the Ministry of Health. By 2002, as many as 230
physicians had passed the test, and another 600 or more took part in the test in
the first half of 2003. The city will offer further education and training on
being a family physician for those that have passed the test, in order to
improve their knowledge, skill and service standard consistently. Furthermore,
the government is working on preferential policies to encourage doctors with
both clinical medical experience in higher-level hospitals and family physician
training to serve in community medical service centers. Through the above
measures, we wish to build up a dependable and qualified medical service team.
5.3 Grant more subsidies to community medical service
In
2003, the Shanghai government worked out a plan for a public sanitation system.
The plan clarified the government's responsibility of public health, and
included community medical services in economic development. Therefore, the
government vows to give more supports to community medical service. Each
community is to have at least one medical service center. The city government
will provide the center with essential operating expenses, housing, elementary
facilities and will cover the expense on its equipment, maintenance and
renovation. Giving policy priority to health care and prevention, the government
subsidy on this section will increase every year till it reaches 200,000 yuan in
2005. It aims to keep community members healthy as long as possible, so they
fall sick as little as possible, and stay well always. Hopefully, the occurrence
of complications should be reduced to as little as possible, thus improving the
citizen's health and living standard.
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